A4438 — Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each
A4438 is a HCPCS Level II code for adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A4438 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- DME supplier
- 30 units MAI 3 — Date of Service Edit: Clinical · Nature of Equipment
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A4438
- Long descriptor
- Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each
- Short descriptor
- Adhesive clip ext ens contr
- Added
- April 1, 2024
- BETOS
- D1F
- Pricing indicator
- 38 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Orthotics, prosthetics, prosthetic devices and vision services. Price subject to floors and ceilings.
Codes adjacent to A4438
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4438 is not quite right, the correct code is very often within a few positions of it.
- A4430Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
- A4431Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each
- A4432Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each
- A4433Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each
- A4434Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each
- A4435Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each
- A4436Irrigation supply; sleeve, reusable, per month
- A4437Irrigation supply; sleeve, disposable, per month
- A4450Tape, non-waterproof, per 18 square inches
- A4452Tape, waterproof, per 18 square inches
- A4453Rectal catheter with or without balloon, for use with any type transanal irrigation system, each
- A4455Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
- A4456Adhesive remover, wipes, any type, each
- A4457Enema tube, with or without adapter, any type, replacement only, each
- A4458Enema bag with tubing, reusable
- A4459Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type
Questions about A4438
What is HCPCS code A4438?
A4438 is a HCPCS Level II code for adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4438?
The CMS HCPCS file marks A4438 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is A4438 paid under the physician fee schedule?
A4438 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.